Fats and factors: lipid profiles associate with personality factors and suicidal history in bipolar subjects

Simon J Evans, Alan R Prossin, Gloria J Harrington, Masoud Kamali, Vicki L Ellingrod, Charles F Burant, Melvin G McInnis, Simon J Evans, Alan R Prossin, Gloria J Harrington, Masoud Kamali, Vicki L Ellingrod, Charles F Burant, Melvin G McInnis

Abstract

Polyunsaturated fatty acids (PUFA) have shown efficacy in the treatment of bipolar disorder, however their specific role in treating the illness is unclear. Serum PUFA and dietary intakes of PUFA associate with suicidal behavior in epidemiological studies. The objective of this study was to assess serum n-3 and n-6 PUFA levels in bipolar subjects and determine possible associations with suicidal risk, including suicidal history and relevant personality factors that have been associated with suicidality. We studied 27 bipolar subjects using the NEO-PI to assess the big five personality factors, structured interviews to verify diagnosis and assess suicidal history, and lipomics to quantify n-3 and n-6 PUFA in serum. We found positive associations between personality factors and ratios of n-3 PUFA, suggesting that conversion of short chain to long chain n-3s and the activity of enzymes in this pathway may associate with measures of personality. Thus, ratios of docosahexaenoic acid (DHA) to alpha linolenic acid (ALA) and the activity of fatty acid desaturase 2 (FADS2) involved in the conversion of ALA to DHA were positively associated with openness factor scores. Ratios of eicosapentaenoic acid (EPA) to ALA and ratios of EPA to DHA were positively associated with agreeableness factor scores. Finally, serum concentrations of the n-6, arachidonic acid (AA), were significantly lower in subjects with a history of suicide attempt compared to non-attempters. The data suggest that specific lipid profiles, which are controlled by an interaction between diet and genetics, correlate with suicidal history and personality factors related to suicidal risk. This study provides preliminary data for future studies to determine whether manipulation of PUFA profiles (through diet or supplementation) can affect personality measures and disease outcome in bipolar subjects and supports the need for further investigations into individualized specific modulations of lipid profiles to add adjunctive value to treatment paradigms.

Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Figure 1. Schematic of biosynthetic pathway for…
Figure 1. Schematic of biosynthetic pathway for common n-3 and n-6 fatty acids.
Major dietary inputs are shown with arrows and enzymes catalyzing each conversion are given.
Figure 2. Scatter plots of ALA:EPA ratio,…
Figure 2. Scatter plots of ALA:EPA ratio, EPA:DHA ratio and both agreeableness and extraversion factor scores.
Graphs show significant correlations between ALA:EPA and agreeableness (p = 0.023, r = −0.436) and extraversion (p = 0.045, r = −0.389) and significant positive correlations between EPA:DHA and agreeableness (p = 0.024, r = 0.433) and extraversion (p = 0.048, r = 0.384).
Figure 3. Scatter plot of openness factor…
Figure 3. Scatter plot of openness factor score and (a) serum ALA:DHA ratio or (b) FADS2 activity.
Graphs show a significant negative correlation between openness factor score and serum ALA:DHA ratio (p = 0.008, r = −0.498) and a significant positive correlation between openness factor score and FADS2 activity (p = 0.036, r = −0.406).
Figure 4. Bar graph of differences in…
Figure 4. Bar graph of differences in serum AA concentration between subjects with and without a history of suicide attempt.
Serum AA is plotted for both suicide attempters and non-attempters; error bars show standard deviation (p = 0.026).

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